20.500.12556/DiRROS-19357 Percutaneous mechanical thrombectomy in patients with high-risk pulmonary embolism and contraindications for thrombolytic therapy Background. High-risk pulmonary embolism is associated with a high early mortality rate. We report our experience with percutaneous mechanical thrombectomy in patients with high-risk pulmonary embolism and contraindications for thrombolytic therapy.Patients and methods. This was a retrospective analysis of consecutive patients with high-risk pulmonary embolism and contraindications to thrombolytic therapy. They were treated with percutaneous mechanical thrombectomy which included thrombectomy and additional thrombus aspiration when needed. Clinical parameters and survival to discharge were measured. Results. From November 2005 to September 2015 we treated 25 patients with a mean age of 62.6 +- 12.7 years, 64% were men. Mean simplified Pulmonary Embolism Severity Index was 2.9. Mean maximum lactate levels were 7.8 +- 6.6 mmol/L, vasopressors were used in 77%, and 59% needed mechanical ventilation. Mechanical treatment included thrombus fragmentation complemented with aspiration (56%) and aspiration using Aspirex S catheter (44%). Local (5 patients; 20%) and systemic (3 patients; 12%) thrombolytics were used as a salvage therapy. We observed nonsignifi-cant improvements in systemic blood pressure (100 +- 41 mm Hg vs 119 +- 34; p = 0.100) and heart frequency (99 +- 35 min-1vs 87 +- 31 min-1; p = 0.326) before and after treatment, respectively. Peak systolic tricuspid pressure gradient was significantly lower after treatment (57 +- 14 mm Hg vs 31 +- 3 mm Hg; p = 0.018). Overall the procedure was technically successful in 20 patients (80%) and 17 patients (68%) survived to hospital discharge. Conclusions. In patients with high-risk pulmonary embolism who cannot receive thrombolytic therapy, percutaneous mechanical thrombectomy is a promising alternative to reduce pulmonary artery pressure. high-risk pulmonary embolism treatment percutaneous mechanical thrombectomy pljučna embolija z visokim tveganjem zdravljenje perkutana mehanska trombektomija true false true Association of Radiology and Oncology Ljubljana Angleški jezik Slovenski jezik by Authors Neznano 2024-07-16 11:13:22 2024-07-16 11:13:23 2024-07-17 03:59:13 0000-00-00 00:00:00 2020 0 0 Soavtorji: Klemen Steblovnik, Simona Zorman, Peter Popovic; str. 62-67, VII no. 1 Vol. 54 2020 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 2020-01-01 616.1 1318-2099 10.2478/raon-2020-0006 34732249 https://www.degruyter.com/downloadpdf/j/raon.ahead-of-print/raon-2020-0006/raon-2020-0006.pdf 1 e3a2eda0-4342-11ef-b487-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=26690 RAZ_Bunc_Matjaz_2020.pdf RAZ_Bunc_Matjaz_2020.pdf 1 7952E0E8696982517290A3549CF2F912 d26cf0af57b81e1a6a1217381201faab14ea902ee29685cc2562286d7293c3dc 09921fc9-4343-11ef-b487-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=26691 Onkološki inštitut Ljubljana 0 0 0